Pharmacist, Population Health

Navitus; Boston (MA); Remote; USD 110,000 - 150,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off (PTO)

Parental leave

Paid holidays

401K match

Adoption assistance

Flexible Spending Account

Educational assistance

Professional memberships

Referral bonus

Job summary

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team. You will develop and administer Navitus Clinical Programs including RDUR, Health Management, Pharmacogenomics, and MTM across all lines of business.

You will review health outcomes data, maintain evidence-based docs, and support program management. Collaboration with Account Management, Lumicera, and P&T Committee is essential to deliver clinically sound, cost-effective programs.

Qualifications

• Bachelor’s degree in Pharmacy or PharmD required.
• Current, unrestricted licensure as a Pharmacist in the state of residence, or reciprocity within 4 months.
• 2+ years of clinical experience, or residency and 1-year clinical experience.
• Knowledge of PBM industry, formulary management, pharmacy claims and managed care principles.
• Proficiency in drug literature and clinical trial evaluation; MS Word/Excel/PowerPoint preferred.
• Proficiency in MS Word, Excel, PowerPoint including tables, charts and figures.
• Participate in, adhere to, and support compliance program objectives.
• Ability to interact cooperatively with others.

Responsibilities

• Lead the development of new clinical programs and maintain existing ones.
• Facilitate communication and education to clients, members, providers, and staff.
• Provide clinical outreach to members, prescribers, and providers to enhance care coordination.
• Support operational departments in implementing PBM programs and daily functions.
• Communicate standards (Medicare Part D, PQA, HEDIS) to stakeholders clearly.
• Assist Residency Program Director with PGY1 residency program.
• Provide leadership and strategic direction to Product Managers.
• Engage with the Specialty Clinical Group.
• Participate in Coverage Determination processes when needed.
• Provide clinical input to formulary decisions made by the P&T Committee.

Skills

Clinical pharmacology

PBM industry knowledge

Pharmacotherapy expertise

Communication skills

Education

Doctor of Pharmacy (PharmD) or equivalent

Current, unrestricted pharmacist licensure

Tools

MS Word

Excel

PowerPoint

Job description

Overview

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team!

The Pharmacist, Population Health will be responsible to perform duties related to the development, implementation, outcomes reporting, and ongoing administration and support of Navitus Clinical Programs including Drug Utilization Review (i.e., RDUR, CDUR), Health Management (i.e., clinical edits, Asthma Management, COPD Management, Pharmacogenomics, Pharmacoadherence, Prescriber Insights, MTM), and other strategic clinical initiatives (i.e., Residency Program) across all lines of business. The Pharmacist, Population Health will also provide support to other clinical areas including Account Management, Lumicera, Drug Information and Pipeline, and the Pharmacy and Therapeutics (P&T) Committee.

Additionally, the Pharmacist, Population Health is responsible for reviewing, evaluating, and sharing the health outcomes and utilization data for program management and development. The Pharmacist, Population Health will develop and maintain appropriate clinical, evidence-based documentation that supports PBM programs. The primary functions involve ensuring that Navitus can provide clinically sound programs (including products, edits, and reports) in the most cost-effective manner and utilize technology to implement clinical programs. This utilization of technology frequently involves translation between technical guidelines and clinical program business requirements as well as program testing.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• Lead the development of new clinical programs and manage the maintenance of existing programs
• Facilitate communication and education to clients, members, providers, and internal staff regarding clinical programs and program outcomes
• Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination
• Provide support to operational departments on the implementation of various PBM programs and daily functioning in support of member/patient quality of care. This involves frequent interdepartmental collaboration and guidance to develop, implement, and maintain all clinical programs
• Have strong knowledge of various standards, regulations, and guidance including Medicare Part D, PQA, and HEDIS measures and concisely communicate that information to stakeholders and clients
• Assist Residency Program Director (RPD) with the PGY1 Managed Care Residency Program
• Provide leadership, training, supervision, and strategic direction to Product Managers
• Provide expertise through active involvement with the Specialty Clinical Group
• Participate in the Coverage Determination (Certification, Prior Authorization, Medical Exception, Exception to Coverage, etc.) process when needed
• Provide clinical expertise related to formulary decisions made by the P&T Committee and Formulary Advisory Committee
• Other duties as assigned

Qualifications

What our team expects from you?

• Bachelor’s degree in Pharmacy or PharmD required.
• Current, unrestricted licensure as a Registered Pharmacist in the state of residence, or the ability to gain reciprocity within 4 months.
• 2+ years of clinical experience, or clinical or managed care pharmacy practice residency and 1-year clinical experience.
• Knowledge of PBM industry, formulary management, pharmacy claims and managed care principles and practices desired.
• Proficiency in drug literature and clinical trial evaluation, including proficiency with electronic databases (e.g., Micromedex, Medline, Facts & Comparisons) preferred.
• Proficiency in MS Word, Excel, PowerPoint including tables, charts and figures preferred
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Navitus?

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program - up to $750!

#LI-Remote

Navitus Health Solutions is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other characteristic protected by law.

Equal employment opportunity, including veterans and individuals with disabilities.

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